International Journal of General Medicine (Aug 2022)
Increasing the Status of Hospital General Medicine Departments with Emphasis on Outpatient Care in Japan
Abstract
Shun Yamashita,1 Hiroyuki Nagano,2 Taku Harada,3 Taiju Miyagami,4 Kosuke Ishizuka,5 Masatomi Ikusaka5 1Department of General Medicine, Saga University Hospital, Saga, Japan; 2Department of Healthcare Economics and Quality Management, Graduate School of Medicine, Kyoto University, Kyoto, Japan; 3Division of General Medicine, Showa University Koto Toyosu Hospital, Tokyo, Japan; 4Department of General Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan; 5Department of General Medicine, Chiba University Hospital, Chiba, JapanCorrespondence: Shun Yamashita, Department of General Medicine, Saga University Hospital, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan, Tel +81952343238, Fax +81952342029, Email [email protected]: Demand is increasing for general medicine services in Japan, a super-aged society. The new medical specialty system introduced in 2019 obligates physicians to obtain a qualified specialty from among 19 basic specialty fields, including general medicine, before obtaining more advanced qualified subspecialties. The role of the department of general medicine in Japan varies in each hospital. Remuneration for medical services obtained by general medicine departments that mainly provide outpatient care is relatively low, making it difficult to fill positions in this department within a hospital. We conducted a narrative review and discussed ways to increase the status of hospital general medicine departments that mainly provide outpatient care. We consider the following four points to be important: improvement of diagnostic capabilities in the outpatient setting; playing a central role in education for medical students and residents; active involvement with patients who have diagnostic difficulties or social problems; and branding and promotion of the general medicine department. We envision that adopting an active approach to these points will increase the status of general medicine departments that mainly provide outpatient care within the hospital, allowing such newly established departments to start easily in Japanese hospitals in the future.Keywords: general medicine, outpatient, diagnostic capability, education, difficult diagnosis, branding
